710290.pdf_.. _
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POSTED ON KROLL MAP NO.: I PERMIT
EM NUMBER
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BUILDING DEPARTMENT=Insidelleavy
Flll / UL
PERMIT APPLICATION Linoe JOB ADDRESS 9 / I I
NAME ( F! /tJ — /�/ / %�....,. A� i nL.AA VARn aFTRActt i
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I/� I NEW
® RESIDENTIAL
❑
LINE
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❑
NON-RESIDENTIAL
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SIGN
❑ ADD
RETAINING
❑
O
WALL
DEMOLISH
ALTER
❑
EXAVATPE
ORCFILL E
❑
(ENC x
Ft.)
..........
REPAIR
❑
INSP.
wim
POOL
rUMBER OF STORIES
NUMBER OF
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DWELLING
UNITS
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I hereby acknowledge that I have read this application; that the In-
formation given In correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days: MOVED -IN BUILDINGS shalt be com-
pleted In six months.)
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
-5 /
YES n NO
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W G.!..FT. ... L1... FT. 0
REMARKS Driveway slopes not to exceed those of
indicated on Standard Drawing #103.
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FIRE ZOW$-- I TYPE OF
YES
Plan Check No.
BUILDING
PLUMBING
HEAT & GAB LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR d-1107
�PM UPC t 1-70
N
YES ❑ NO
CITY OF EDMONDS. LOCAL
Valuation I Fee
APPLICATION APPROVAL
F
e
OWO
No.
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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RECORD OF INSPECTIONS
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Date Passed
Foundation
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Date. Passed I.
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Drainage
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